Individual
STEPHEN MICHAEL LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
11 SHAWMUT AVE, BRADFORD, MA 01835-7930
(412) 992-7921
Mailing address
11 SHAWMUT AVE, BRADFORD, MA 01835-7930
(412) 992-7921
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP007567
PA
Other
Enumeration date
08/20/2013
Last updated
05/06/2014
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